Estrogen and androgen hormone levels affect acne formation in women. Low estrogen and high androgen levels cause cystic acne. Birth control pills can help regulate hormone levels and reduce acne. Androgens stimulate sebum production, leading to bacteria growth and inflammation. Progesterone can also worsen acne by reducing pore size.
The relationship between estrogen and acne is somewhat complex because hormonal fluctuations in the normal female menstrual cycle can cause acne at different times. Low levels of estrogen and proportionally higher levels of androgen hormones generally cause estrogen-related cystic acne. Hormonal imbalances that reduce estrogen levels or increase androgen levels will increase the likelihood of acne formation because they increase the amount of oil produced by the sebaceous glands under the skin’s surface. Birth control pills can relieve severe acne, as they carefully maintain estrogen and androgen levels in the bloodstream.
Androgens are the main hormonal cause of acne in many women. These hormones are what stimulate the sebaceous glands to produce an oily substance known as sebum. Too much of this substance can often get stuck in pores, providing a breeding ground for common skin bacteria to multiply beneath the skin’s surface. Once the bacteria have multiplied, they can often cause inflammation, which leads to cystic acne. Estrogen is able to nullify or mask the effects of androgens on the body.
High estrogen levels and acne occur at opposite times in a typical menstrual cycle. During the first half of the cycle, before ovulation occurs, estrogen levels gradually increase. This not only reduces the effects of androgens in the body but also reduces the occurrence of acne. The body reaches its estrogen peak just before ovulation, after which estrogen levels gradually decline. Acne usually increases after ovulation in the time known as the luteal phase and gets worse just before menstruation.
During the luteal phase of the cycle, progesterone, a hormone that has both estrogenic and androgenic properties, gradually increases. Fluctuations in progesterone can increase swelling and fluid levels, which in turn constricts the pores in the face. This reduction in pore size often makes acne symptoms worse because it further limits the body’s ability to get rid of excess oil.
Birth control pills deliver carefully controlled levels of estrogen and progesterone into the bloodstream. By keeping estrogen levels constant throughout the month, the pills are able to reduce the effects of androgens during the luteal phase as well as reduce overall hormonal fluctuations. This ultimately leads to a reduction in acne for many women, especially those who have experienced severe hormonal imbalances prior to starting treatment.
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